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      Body Weight Misperception and Its Association with Unhealthy Eating Behaviors among Adolescents in China

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          Abstract

          This study aims to examine associations between body weight misperception and eating behaviors among Chinese adolescents. Students ( N = 2641) from a middle school and a high school in Wuhan, China participated in a cross-sectional study in May 2016. A questionnaire based on the World Health Organization’s Global School-Based Student Health Survey was employed to assess responses. Self-reported data, including weight, height, body weight perception, and eating habits, were collected. Body Mass Index (BMI) for age z-score was calculated from self-reported height and weight using WHO AnthroPlus. We used descriptive, logistic regression analysis and a Kappa test to analyze the data using SPSS. Overall, 56.6% of participants did not correctly categorize their weight status; these were much more likely to be girls. Compared with the correctly-perceived group, those who underestimated their weight tended to report eating late at night, having dinners with family, and checking nutrition labels. In contrast, weight overestimating students were less likely to report eating late at night, having breakfasts with family, having dinners with family, and discussing nutrition topics over meals. Body weight misperception was associated with unhealthy eating behaviors among Chinese adolescents.

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          Does perception equal reality? Weight misperception in relation to weight-related attitudes and behaviors among overweight and obese US adults

          Background Weight misperception might preclude the adoption of healthful weight-related attitudes and behaviors among overweight and obese individuals, yet limited research exists in this area. We examined associations between weight misperception and several weight-related attitudes and behaviors among a nationally representative sample of overweight and obese US adults. Methods Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were used. Analyses included non-pregnant, overweight and obese (measured body mass index ≥ 25) adults aged 20 and older. Weight misperception was identified among those who reported themselves as "underweight" or "about the right weight". Outcome variables and sample sizes were: weight-loss attitudes/behaviors (wanting to weigh less and having tried to lose weight; n = 4,784); dietary intake (total energy intake; n = 4,894); and physical activity (meets 2008 US physical activity recommendations, insufficiently active, and sedentary; n = 5,401). Multivariable regression models were stratified by gender and race/ethnicity. Analyses were conducted in 2009-2010. Results These overweight/obese men and women who misperceived their weight were 71% (RR 0.29, 95% CI 0.25-0.34) and 65% (RR 0.35, 95% CI 0.29-0.42) less likely to report that they want to lose weight and 60% (RR 0.40, 95% CI 0.30-0.52) and 56% (RR 0.44, 95% CI 0.32-0.59) less likely to have tried to lose weight within the past year, respectively, compared to those who accurately perceived themselves as overweight. Blacks were particularly less likely to have tried to lose weight. Weight misperception was not a significant predictor of total energy intake among most subgroups, but was associated with lower total energy intake among Hispanic women (change -252.72, 95% CI -433.25, -72.18). Men who misperceived their weight were less likely (RR 0.68, 95% CI 0.52-0.89) to be insufficiently active (the strongest results were among Black men) and women who misperceived their weight were less likely (RR 0.74, 95% CI 0.54, 1.00, p = 0.047) to meet activity recommendations compared to being sedentary. Conclusion Overall, weight misperception among overweight and obese adults was associated with less likelihood of interest in or attempts at weight loss and less physical activity. These associations varied by gender and race/ethnicity. This study highlights the importance of focusing on inaccurate weight perceptions in targeted weight loss efforts.
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            Body image and eating disorders amongst Japanese adolescents. A review of the literature.

            This review describes the prevalence of eating disorders and disordered eating behaviors as well as factors influencing body image disturbance amongst Japanese adolescents and compares the prevalence and trends with those of Westernized countries. Although eating disorders have been previously regarded as peculiar to Western society, they are now a more global issue with reports of non-Western countries including Japan having increasing rates of eating disorders. As the aetiology of eating disorders is related to societal norms, culture and ethnicity, their study requires an understanding of body image disturbance within different cultural contexts. Although considered less prevalent than in the West, Japan has an early history of eating disorder research and trends outlined in this review suggest that, as in Western countries the interest in, and study of eating disorders in Japan has increased during the 1980s. The prevalence of eating disorders in Japan based on available reviews, epidemiological studies and clinical reports ranges from 0.025% to 0.2% for AN and from 1.9% to 2.9% for BN. Studies suggest that the prevalence of eating disorders has increased significantly during the past two decades but the prevalence is still quite low compared to those in Western countries. Strategies for culturally appropriate prevention are discussed. 2009 Elsevier Ltd. All rights reserved.
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              Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents.

              Rapid economic development accompanied by imported Western media, advertising, fashion, and lifestyle in mainland China has resulted in shifts in cultural beliefs and beauty ideals in adolescents. The present study focused on understanding relationships among weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents. Data collected in 2002 from 6863 middle and high school students and their parents from four large cities in mainland China were used. Weight status was determined by measured weight and height. Weight perception, media exposure, attitudes, and health behaviors were assessed by a structured questionnaire survey. Boys were more likely to describe themselves as either too thin or relatively thin than girls (37.32% vs. 18.79%), while girls more often considered themselves either relatively heavy or too heavy than boys (50.83% vs. 26.54%). Girls who were actually normal or underweight were more likely than boys to describe themselves as either relatively heavy or very heavy (41.6% vs. 11.6%), while boys who were actually normal or overweight were more likely than girls to believe themselves as underweight (30.9% vs. 15.7%). Girls who were frequently exposed to media from Japan, Korea, Hong Kong, and Taiwan, and placed high value on their physical appearance, were more likely to be dissatisfied with their body weight, which in turn were more likely to restrict consumption of certain foods, smoke cigarettes, and drink alcohol. Similar results were not observed in boys. Weight dissatisfaction was prevalent in Chinese adolescents and was significantly related to media exposure, attitudes towards physical appearance, and adoption of certain health-risk behaviors in girls. Our findings underscore the importance of sociocultural influences in shaping realistic body image and have implications for prevention and early intervention for establishing health behavioral practices during adolescence.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                08 May 2018
                May 2018
                : 15
                : 5
                : 936
                Affiliations
                [1 ]School of Health Sciences, Wuhan University, Wuhan 430071, China; yanlq7@ 123456hotmail.com (H.Y.); yingru.wu@ 123456hotmail.com (Y.Wu.); ylcz2920@ 123456126.com (X.Z.); elle529@ 123456126.com (Y.Wa.)
                [2 ]Cerus Consulting, LLC, Winston-Salem, NC 27101, USA; toniffrey@ 123456gmail.com
                [3 ]Abt Associates, Durham, NC 27703, USA; Jason_brinkley@ 123456abtassoc.com
                [4 ]College of Life Sciences, South-Central University for Nationalities, Wuhan 430074, China; zhangrui@ 123456mail.scuec.edu.cn
                [5 ]Department of Nutrition, The University of Tennessee, Knoxville, TN 37996, USA; gchen6@ 123456utk.edu
                [6 ]Department of Family & Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
                [7 ]Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
                [8 ]Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
                Author notes
                [* ]Correspondence: rli@ 123456whu.edu.cn (R.L.); jusmoore@ 123456wakehealth.edu (J.B.M.); Tel.: +86-27-6875-8591 (R.L.); +1-336-716-3702 (J.B.M.); Fax: +86-27-6875-8648 (R.L.); +1-336-716-3206 (J.B.M.)
                Author information
                https://orcid.org/0000-0001-7698-6927
                https://orcid.org/0000-0003-4059-0538
                Article
                ijerph-15-00936
                10.3390/ijerph15050936
                5981975
                29738429
                2d71dddc-ddb5-49ac-b699-58f7d4401579
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 05 March 2018
                : 04 May 2018
                Categories
                Article

                Public health
                body weight misperception,unhealthy eating behaviors,adolescents
                Public health
                body weight misperception, unhealthy eating behaviors, adolescents

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